†
This study used the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the Applied Research Program, National Cancer Institute; the Office of Research, Development, and Information, Centers for Medicare and Medicaid Services; Information Management Services, Inc.; and the SEER Program tumor registries in the creation of the SEER-Medicare database. We thank Winnie Ricker (Information Management Services, Rockville, MD) for assistance with database management.

Abstract

BACKGROUND:

The cause of chronic fatigue syndrome (CFS) is unknown but is thought to be associated with immune abnormalities or infection. Because cancer can arise from similar conditions, associations between CFS and cancer were examined in a population-based case-control study among the US elderly.METHODS:

Using linked Surveillance, Epidemiology, and End Results (SEER)-Medicare registry data, approximately 1.2 million cancer cases and 100,000 controls (age range, 66-99 years; 1992-2005) were evaluated. CFS was identified in the period more than 1 year prior to selection, using linked Medicare claims. Unconditional logistic regression was used to estimate the odds ratios (ORs) comparing the CFS prevalence in cases and controls, adjusting for age, sex, and selection year. All statistical tests were 2-sided.RESULTS:

This looks a little suspect to me: can't see why they are using only95% confidence intervals when looking at so many different cancers (ie so many different comparisons). And those Odds Ratios are tiny (eg NHL OR 1.29 [95% CI 1.16-1.43]). Add in that the CFS cases are not rigorously diagnosed (ie from Medicare claims)then sadly I don't think this tells us much. Sorry to pour cold water on this.

This appears to be an NIH based study. The data might not be as great as we'd like (limited to ICD code entries). but the way the results are being presented in this way shows you these authors are treating CFS seriously.

Here is a quote from the paper:

The findings of altered immune function in CFS, along with data from other contexts that implicate immune disturbances or viral infections in the etiology of DLBCL and MZL, suggest that an etiologic relationship underlies the observed associations in our study.

This appears to be an NIH based study. The data might not be as great as we'd like (limited to ICD code entries). but the way the results are being presented in this way shows you these authors are treating CFS seriously.
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Yeah... politically there are things which make me feel hopeful, but I try to stay critical regardless of that, perhaps even in a slightly unfair manner.

I really don't know anything about immune activation etc in CFS, or the known implications of differing rates of certain types of cancer. If this study is building upon other compelling work, then it's conclusion might be more justified. I probably should have kept quiet!

1 in every 200 people have CFS? Maybe with a very broad definition of CFS.

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That wouldn't be 1 in 200 people have CFS, it would be 1 in 200 people who have filed Medicare claims have CFS. You would expect the percentage of sick people who have ME/CFS to be higher than the percentage of the general population.

[Note: an OR (odds ratio) of 1.0 would signify no difference in average risk between CFS & non-CFS populations. An OR of 1.88, for example, would indicate an 88% greater average risk for the CFS population. OR of 1.51 would be 51% greater average risk, and so on.]

Abstract:Summary: Using US linked registry data on 1.2 million cancer cases and 100,000 population-based controls, risk was evaluated for a wide range of cancer types following a diagnosis of chronic fatigue syndrome. A strongly significant elevated risk was found for non-Hodgkin lymphoma associated with chronic fatigue syndrome, and in particular, associations for 2 specified non-Hodgkin lymphoma subtypes (diffuse large B cell lymphoma and marginal zone lymphoma).

Background: The cause of chronic fatigue syndrome (CFS) is unknown but is thought to be associated with immune abnormalities or infection.

Because cancer can arise from similar conditions, associations between CFS and cancer were examined in a population-based case-control study among the US elderly.

CFS was identified in the period more than 1 year prior to selection, using linked Medicare claims. Unconditional logistic regression was used to estimate the odds ratios (ORs) comparing the CFS prevalence in cases and controls, adjusting for age, sex, and selection year. All statistical tests were 2-sided.

Results:

• CFS was present in 0.5% of cancer cases overall and 0.5% of controls [1 in 200 people in Medicare database].

CFS associations with non-Hodgkin lymphoma overall and NHL subtypes remained elevated after excluding patients with medical conditions related to CFS or non-Hodgkin lymphoma, such as autoimmune conditions.

The authors note: This study used the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the Applied Research Program, National Cancer Institute; the Office of Research, Development, and Information, Centers for Medicare and Medicaid Services; Information Management Services, Inc.; and the SEER Program tumor registries in the creation of the SEER-Medicare database. We thank Winnie Ricker (Information Management Services, Rockville, MD) for assistance with database management.

actually some data has suggested CFS is linked Non Hodgkins Lymphoma for 2 decades but the data has been sparse and the subject hardly studied. A Univ of Nevada at Reno researcher presented data at the Reno IACFS/ME conference that appeared to indicate a connection but the study was never published...However good this study is it is intriguing that this particular cancer popped up again..(what are the odds of that?); maybe it will give an impetus to get that other study published.

Don't know much about x-ray source radiation, I do know that low level raditation actually stimulates the immune system among others in a beneficial way, the Victorians were drinking the stuff, some names from that time still survive such as Radox, now manufacturing bath products.

Anyway to the point, isn't it more likely that the constant swelling/pain of lymph glands plays a role, I'm likely to have swelling or pain in one or another set on an at least twice monthly basis.

If I ignore the suggestion that I'm simply imagining this symptom then clearly something is 'happening' to my lymph system that it doesn't like, only other time I've had such symptoms has been during acute infection.

Anyone know if the psyc's have ever done such a patient review to see if there's a link between 'any' psychatric disorder and Non Hodgkins Lymphoma, for instance could there be a link betwee unremitting stress and NHL?

In this it says: "Through use of medical records and Medicare claims, researchers discovered the risk of non-Hodgkin lymphoma (NHL), late in life, was 29 times greater in those with ME/CFS. The risk of other forms of cancer did not appear to be elevated."

It was pointed out in the comments though that the real risk is still uncertain, this is only a place to start.

Based on this http://seer.cancer.gov/statfacts/html/nhl.html it can be seen that the incidence of lymphoma is 19.6 per 100,000 though there are subgroups. Allowing for a tentative 29 fold increase, the incidence of lymphoma in CFS can be approximated to 568 per 100,000. That is about 1 in 176, though the figure may not hold in a younger group or between sexes.

Using an age adjusted death rate of 6.6 per 100,000, an estimation of deaths in CFS might be 191 per 100,000. Again, this is only tentative.